What Health Insurance Covers
In a democratic nation that is run on a capitalistic economy we must all have health insurance to pay for the exceedingly high costs of health care. Some of the simplest procedures can empty your wallet, not to mention what a serious health issue could do to your bank account, and even your available credit. With medical insurance you have the option of paying for a coverage that can pay for almost all medical costs (for the very wealthy) to coverage that is very weak, and does not cover most medical expenses (for the poor, or the cheap).
Health insurance will enable you to get correct & sufficient medical treatment. Your health insurance will look after the expenses of your regular check ups, visits to doctors, specialists if needed, hospitalization expenses & emergency calls. In case of tests like X- ray, MRI or any therapy, the health insurance will reimburse these expenses at prescribed rates. In a few cases you may get cent per cent reimbursement, but in most of the cases you have to shell out a small fraction of amount & the rest of it is covered by insurance.
Health insurance policies mostly stipulate certain limits per person or per family, up to which the expenses are to borne by you & when such limit is crossed, you have to pay only a small percentage of expenses as stipulated in the policy. Some health insurance policies expect you to get the treatment from the hospitals on their list only while some insurers allow you to get the treatment from any hospital of your choice. Some policies stipulate that you can avail specialist?s treatment only if you are referred to a specialist by general practitioner.
It important to know that your medical coverage may cover only for the surgery not for all the treatments the doctor is prescribing. Its best to ask your medical insurance representative to find out what your insurance would cover. You need to have a good knowledge in the policy you have and its good to refer a handbook to learn about it. You are responsible for all the medical bills that are not covered by your insurance.
Medical insurance is only if you fall ill and it does not cover for donating your kidney or bone marrow. It also does not cover for skin or hair transplantation treatments. Breast augmentation, nose reshaping, tummy tucks and stapled stomach treatments are also not covered.
All surgeries will have coverage for any rehab fees that are needed, as previously stated, in accordance to the Doctor?s advice. If the Doctor has not approved of a type of rehab method, or medication, then you will be responsible for the fees that come along with them. Make sure a doctor does not talk you into staying in a hospital longer than necessary.
You must tell your doctor which insurance policy you are having because they generally know the rules & regulations of different companies & in case there are any queries raised, they will be able to answer them in a better way.
Susan Reynolds is the content coordinator for a leading South African Insurance Provider who specialises in Medical Insurance Options.